OAK BROOK, Ill. Coronary computed tomography angiography (CCTA) is an effective tool for determining the risk of heart attacks and other adverse cardiac events in patients with suspected coronary artery disease but no treatable risk factors, such as high cholesterol or high blood pressure, according to a new study published online in the journal Radiology.
"CCTA should be considered as an appropriate first- line test for patients with atypical chest pain and suspected but not confirmed coronary artery disease," said the study's lead author, Jonathon Leipsic, M.D., FRCPC, from the University of British Columbia in Vancouver.
Heart disease is the leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Treatment often involves addressing modifiable cardiovascular risk factors such as elevated cholesterol, high blood pressure, diabetes and smoking. However, some risk factors, like family history, are not modifiable, and no risk models exist to help guide clinicians to identify those symptomatic patients without cardiac risk factors who are at an increased risk of death and myocardial infarction.
"This scenario, where patients are symptomatic but have no cardiac risk factors, comes up often in clinical practice," Dr. Leipsic said. "We lack a good tool to stratify these patients into risk groups."
CCTA is a noninvasive test that has shown high accuracy for the diagnosis or exclusion of coronary artery disease in individuals. However, referral for patients with suspected coronary artery disease is often based on clinical risk factor scoring. Less is known about the prognostic value of CCTA in individuals with no medically modifiable risk factors.
In the first study of its kind, Dr. Leipsic and colleagues correlated CCTA findings with the risk of major adverse cardiac events in 5,262 patients with suspected coronary artery disease but no medically modifiable risk factors. The
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Radiological Society of North America